Jenny McCarthy: An enemy of rational discussion

Earlier this morning, Jenny McCarthy’s re-tweeted to her 225,354 followers the following message: “Pertussis vaccine (whooping cough) legal cause of epilepsy/death of boy. This will NOT make news during ‘outbreaks’ http://bit.ly/i20hmR.” That link brings the reader to a post on Age of Autism (one of whose editors was the source of the initial post, which has already been re-tweeted 50 times), which states unequivocally that a young boy named Elias Tembenis “died as a result of a reaction to his DTaP (P = Pertussis/Whooping Cough) vaccination.” Before I get into the multiple problems with such a statement, here’s some background:

Elias Tembenis was born on August 23, 2000. According to his medical records, his development appeared normal over the course of the first several months of his life. On December 26, he received the second dose of the DTaP vaccine, which is given for diphtheria, tetanus, and pertussis (more commonly known as whooping cough).

The next day, Elias’s parents discovered him having a seizure in his crib and took him to the emergency room. At this point, the clarity regarding his medical history begins to grow more opaque. On the one hand, Elias’s white blood cell count were elevated enough to suggest that the seizure was the result of a previous infection and not a reaction to a vaccine-induced fever; his head circumference was in the 95th percentile for his age, which raised warned flags for a rare genetic condition called Sotos syndrome. (Wikipedia’s description of Sotos syndrome is included at the end of this post) On the other hand, the temporal connection between his DTaP vaccination and his initial seizure suggested some causal correlation was possible, and while Elias’s father’s head was in the 95th percentile for adults, he was perfectly healthy.

By the time Elias was eighteen months old, his doctors indicated that he showed signs of a developmental disorder on the autism spectrum. As time went on, his seizures all but disappeared — he only had one between the beginning of 2003 and the end of 2006 — but it became more obvious that he did, indeed, have a pervasive developmental disorder. Despite a lingering uncertainty over his correct diagnosis, his medical charts repeatedly mentioned Sotos syndrome

On November 16, 2007, three months past his seventh birthday, Elias was brought to the hospital with a fever and a cough. While there, he went into “status epilepticus” followed by “bradycardiac arrest” — in other words, he had an epileptic seizure and a heart attack. He died the next day.

Three-and-a-half weeks ago, a federal judge presiding over a special branch of the US Federal Claims Court that deals with compensation claims stemming from routine childhood vaccination (the official site of what’s commonly referred to as the Vaccine Court is located here), ruled that Elias’s family was entitled to compensation.

The Vaccine Court is a fascinating institution, and while its functioning and implications are too complicated to get into in the course of a blog post, it’s worth learning more about. (I write about it at some length in several chapters of The Panic Virus.) It’s been the subject of a lot of attention recently because of severaldifferent broad rulings against families that sought compensation for their children’s autism in the Autism Omnibus Proceedings. While Elias Tembenis’s case had at one point been part of the Omnibus proceedings, his family decided to argue it on its own merits instead of lumping it in with those of thousands of other families.

What’s important to note here is that the burden of proof in Vaccine Court is dramatically different from that in typical court cases: Usually, the prosecution must prove their case “beyond a reasonable doubt.” In the Vaccine Court, the plaintiffs (or “Petitioners,” as they’re called), need only make a medically and scientifically plausible argument that a given condition could have been the result of vaccination. Once that has been established, families are entitled to compensation–even if it’s more likely that said condition was not caused by vaccination.

With that in mind, here are some relevant passages of the judge’s ruling (a link to a Google docs copy of the ruling is here, while a link to a pdf download is here) in the Tembenis case (emphasis added):

…I find that Petitioners have established that, in circumstances like Elias’s, a complex febrile seizure can lead to epilepsy. Further, Petitioners have established a logical sequences of cause and effect showing that Elias’s vaccine-induced complex febrile seizure was a legal cause of his subsequent epilepsy. Although the record shows that Elias may have suffered from other conditions, unrelated to vaccination, that increased his risk of developing epilepsy, Respondent [i.e., the federal government] has not shown that those conditions were at work here. In essence, Respondent’s argument is that the vaccination did not cause the epilepsy because, based on the statistics, it is more likely that Elias’s epilepsy was caused by a congenital condition than by a vaccine reaction. This fact, alone, is insufficient to negate causation.

The judge goes on:

Although petitioners have not proven that Elias’s DTaP vaccination was a medically certain cause of his epilepsy and subsequent death, that is not the standard for causation under the Vaccine Act. In enacting the Vaccine Act, Congress made a deliberate choice not to impose on petitioners the burden of producing conclusive scientific proof that an unlikely event actually occurred. Instead a petitioner must only provide reliable scientific evidence to support vaccine causation.

So: There’s clearly no grounds for an unequivocal statement that Elias Tembenis “died as a result of a reaction to his DTaP (P = Pertussis/Whooping Cough) vaccination.” (It’s a little like writing that because a court of law ruled that O.J. Simpson was not guilty of murder, “O.J. Simpson did not murder Nicole Brown Simpson and Ron Goldman.” To flip that on its head, it’s like saying that because Goldman’s family won a civil suit against Simpson, “O.J. Simpson murdered Ron Goldman.”)

The irony here is that, in making flat-out statements, the activists who’ve spent years arguing that vaccines are to blame for virtually every childhood disease in existence aren’t helping their own cause any. First, it opens them up to charges of hypocrisy: Many times in the past, Age of Autism has written that the Vaccine Court has no credibility and that its rulings cannot be trusted (see here, here, and here). Now, when they agree with one of its decisions, they accept its ruling as definitive proof.

It’s also this type of dynamic that causes both sides in this debate to dig in their heels, thereby making any sort of real discussion impossible. Claiming that the Vaccine Court ruled that a young boy was killed by the DPaT vaccine will undoubtedly further enrage those who will forever be convinced that there’s a worldwide conspiracy to cover-up the dangers of vaccines. The end result is that all of those parents will be less likely to engage in any type of constructive conversation with people who disagree with them — and that all of the doctors and scientists and public health officials who believe the years of evidence supporting vaccine safety will be more likely to assume proponents of the vaccines-cause-autism theory will never be able to have a rational discussion on the issue.

Thanks for the nice words. I’m definitely interested in using this forum to engage in as much of an open discussion as possible — but it’s really a one-person site as opposed to a group effort. If there’s something you (or anyone) feels I’ve gotten wrong or am not looking at in the right light, feel free to write about it in the comments. I’m sure there’ll be times when some of those migrate up and are incorporated into an actual post.
Thanks, and Merry Christmas — Seth

Feel free to run a small excerpt of the post and link to it, but please don’t re-post the entire thing on your site. It has taken a lot of money and effort to put this site together and I’d prefer if people actually visit the site to read my work. Thanks.

It would seem that the Sotos question could be resolved via sequencing, if the Wikipedia statement that most cases trace to mutations in the NSD1 gene are accurate. It’s a curious possibility–there must be more to it than the head circumference.

Even for Dr. McCarthy (PhD, Google U), it’s quite a stretch to take an event seven years prior and trace it as the direct cause of death. I don’t expect much from that quarter, but she and the AoA crowd continue to surprise me.

The AoA love-hate for the vaccine courts is no surprise–they have the same relationship with science. It is common for the AoA crowd to decry all science as unfounded or whored out to pharma unless it’s some “finding” they think supports their indefensible stance. Then, suddenly, science is God, second only to Andrew Wakefield in the pantheon.

Hi Seth, thanks for your clarification regarding the Vaccine Court. You’re a voice of reason, and I hope that eventually you extend your influence in the news media beyond the science and towards political discourse.

Hi – thanks for the article. In the interest of full disclosure, I want to let you know that I consider myself anti-current-vaccine-schedule. I think it’s important to note that I’m decidedly not “anti-vaccine,” though some are.
What brings me to comment is that I’m genuinely perplexed by the statements I hear about how safe vaccines are and how much science is available proving their safety beyond any conspiratorial shadow of a doubt, when the CDC’s vaccine safety web page states explicitly that it’s rarely possible to say for certain whether a vaccine caused an adverse event. It further says that it takes a formal scientific study to distinguish between a coincidence and a true reaction … and that safety is determined by the number of adverse events reported. It seems like the only TRUE way we KNOW they’re safe is that we don’t have polio ravaging the country.. which doesn’t say as much about vaccine safety as it does vaccine effectiveness. It sounds like they’re relying on the reporting of adverse events to VAERS, and leaving the burden of proof with the parents of vaccinated kids- parents who are not equipped to conduct the formal scientific study they said is necessary to determine whether a vaccine played a causal role or if the adverse event was coincidental. Does your book address this?

“Many times in the past, Age of Autism has written that the Vaccine Court has no credibility and that its rulings cannot be trusted (see here, here, and here). Now, when they agree with one of its decisions, they accept its ruling as definitive proof.”

Yes. Special Pleading, thy name is anti-vaccination. In Australia we see this fallacious argument from Dorey et al on a daily basis.